Unique surgery said to relieve neck pain

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July 28, 2010 11:55:46 AM PDT

SAN FRANCISCO --

A Bay Area woman has finally found relief from debilitating pain, thanks to a surgery that may be the first of its kind in the world. Doctors in San Francisco literally reversed a spinal fusion in her neck.

For most of the last decade, moving her head the wrong way could have left Bobbie Jo Ramirez in pain. It was so much pain, she decided to risk an experimental surgery.

"Every time I would fall asleep, I would stay in that position for two hours. Every time I would move and turn, I'd wake up from pain," she said.

An accident a decade ago had left this former Sonoma County sheriff's deputy with the equivalent of a triple spinal fusion.

Doctors had placed a solid piece of donor bone in her neck, to replace damaged vertebrae. But something had gone wrong.

"In the process of healing, one of the vertebrae tilted downward and as a result she developed ongoing chronic neck pain," surgeon Dr. Kenneth Light said. "She kept having to tilt head backward because the rest of the body had to tilt forward."

So light laid out a novel approach by literally cutting through bone, to reverse the spinal fusion without damaging the spinal cord.

"I told the patient, I didn't believe it'd ever been done before and I wasn't sure it'd be successful," he said.

The surgery was a radical departure from common treatment because spinal fusion is considered permanent and a last resort from patients suffering from extreme neck pain.

In a five-hour surgery, Light cut and separated the fusion at the point where the donor bone met the vertebrae above it.

He then carefully fitted a disc replacement. It's an artificial device more common in Europe than the U.S., which allows the vertebrae to twist naturally.

"We had to improvise as we went. We weren't sure that we could cut in a way that would be stable in a way that would accept the disc," Light said. "We weren't sure we could separate the vertebrae after 11 years of having a spinal fusion, but you can see nicely the disk replacement fits right to the center portion of the spine.

Though Bobbie Jo is still early in her recovery, she's been able to regain movement in her neck and relief from nearly constant headaches. She now considers the risk worth it.

"If he couldn't do it, then I knew where I was going to be at, that was going to be the point and this is where I have to go from," she said.

Light believes this initial success could lead to alternatives for patients when the spinal fusions don't end the pain.

"So we believe in some cases, people who have trouble from fusions can have the operation reversed. Up to this day, that's only been theory and concept.

Light is now planning to publish the results of the surgery and the techniques he used.